Surgical operation system

ABSTRACT

A plurality of handpieces used to perform an operation is connected to a main operation apparatus, which generates a driving signal, through connectors formed on the main apparatus. When an operator holds a handpiece he/she wants to use, an output line over which the driving signal is transmitted is routed to the held handpiece owing to an output of a sensor that detects a change in capacitance stemming from the hold. The operator therefore need not manually set a mode in which the driving signal is applied to the handpiece he/she wants to use. Moreover, a port number assigned to a port to which the output line is routed is indicated on a display device. The operator can readily identify the usable handpiece.

[0001] The present application cites the basic applications of JapanesePatent Application No. 2000-54181 (filed on Feb. 29, 2000), JapanesePatent Application No. 2000-40501 (filed on Feb. 16, 2001) claiming thepriority of the application No. 2000-54181, and Japanese PatentApplication No. 2000-91904 (filed on Mar. 29, 2000), and enjoys thebenefits of the applications.

BACKGROUND OF THE INVENTION

[0002] 1. Field of the Invention

[0003] The present invention relates to a surgical operation systemincluding a plurality of handpieces. Herein, when a handpiece to be usedis selected by holding the handpiece, routes of an output line overwhich a driving signal is applied to the handpiece are switched, andinformation of the selected handpiece is notified.

[0004] 2. Description of the Related Art

[0005] Ultrasonic knife systems including the one described in, forexample, Japanese Patent Application No. 11-269242 (filed on Sep. 22,1999) have been proposed as surgical operation systems.

[0006] With the prevalence of the operation system, an increasing numberof types of handpieces have come to be used for operations. If aplurality of handpieces suitable for an operation can be connected toone operating apparatus, the plurality of handpieces is changed for useduring a surgical procedure.

[0007] In this type of system, for changing a plurality of handpieces,it is necessary to manipulate a change switch on a front panel of a mainapparatus. Otherwise, a dedicated remote switch is needed to changehandpieces.

[0008] However, when the change switch on the front panel must be usedto change handpieces, since the main apparatus is installed in a filthyzone within an operating room, an operator who performs an operationcannot manipulate the change switch. The operator must ask a nurse orthe like to manipulate the change switch. The operator may find thisannoying.

[0009] Moreover, when the remote switch must be used to changehandpieces, the switch on which an operator steps must be installed in aclean operating zone. This leads to an increase in the number ofswitches with a cord installed in the operating zone. Bettermaneuverability is demanded.

[0010] Moreover, when a plurality of handpieces is used during asurgical procedure, a handpiece changing means is needed to change theplurality of connected handpieces.

[0011] When a plurality of handpieces is connected so that any of thehandpieces can be selected, an operator has difficulty in identifying ahandpiece the operator now holds.

SUMMARY OF THE INVENTION

[0012] An object of the present invention to provide a surgicaloperation system capable of offering excellent maneuverability andoutputting treatment energy from a held handpiece out of a plurality ofconnected handpiece once an operator actually holds the handpiece.

[0013] Another object of the present invention is to provide a surgicaloperation system enabling an operator to identify a handpiece theoperator has now selected even when a plurality of handpieces can beconnected to be able to be selected.

[0014] Still another object of the present invention is to provide auser-friendly endoscopic operation system making it possible to checkinformation of a selected handpiece with an endoscopic image viewedduring an operation under endoscopic observation.

[0015] Still another object of the present invention is to provide asurgical operation system that enables remote control despite its simpleconfiguration and that is easy to use and user-friendly because anoperator is visually informed of a handpiece the operator has selectedand whether the handpiece is outputting energy.

[0016] According to the present invention, a surgical operation systemconsists mainly of a plurality of handpieces, a driving signalgenerator, an output switching unit, hand-held members, hold detectingdevices, and an output switching control unit. The plurality ofhandpieces generates predetermined energies. The driving signalgenerator generates a driving signal with which the plurality ofhandpieces is driven. The output switching unit switches the outputdestinations of the driving signal sent from the driving signalgenerator so as to select any of the plurality of handpieces. Thehand-held members are included in the plurality of handpieces and heldfor treatments. The hold detecting devices are embedded in the hand-heldmembers, and each detect that the hand-held member is held and produce apredetermined hold detection signal. The output switching control unitreceives the hold detection signal and controls the output switchingunit that switches the output destinations of the driving signal toselect a handpiece from which the hold detection signal is transmitted.

[0017] When an operator holds a handpiece the operator wants to use, theoutput destinations of a driving signal are automatically switched toselect the held handpiece. This leads to improved maneuverability foroperations.

BRIEF DESCRIPTION OF THE DRAWINGS

[0018]FIG. 1 to FIG. 7 are concerned with a first embodiment of thepresent invention;

[0019]FIG. 1 shows an overall configuration of an ultrasonic operationsystem in accordance with the first embodiment;

[0020]FIG. 2 is a block diagram showing the internal configuration of amain apparatus;

[0021]FIG. 3 shows the configuration of a hold detecting means;

[0022]FIG. 4A and FIG. 4B are perspective views showing handpiecesincluding hold detection sensors;

[0023]FIG. 5 is a circuit diagram showing the circuitry of a capacitancesensor circuit included in a hold detecting means;

[0024]FIG. 6 is a flowchart describing output port selection;

[0025]FIG. 7 shows the configuration of a hold detecting means inaccordance with a variant;

[0026]FIG. 8 and FIG. 9 are concerned with a second embodiment of thepresent invention;

[0027]FIG. 8 is a perspective view showing the distal end of ascissors-like handpiece;

[0028]FIG. 9 shows the overall configuration of an ultrasonic operationsystem in accordance with the second embodiment of the presentinvention;

[0029]FIG. 10 to FIG. 11C are concerned with a third embodiment of thepresent invention;

[0030]FIG. 10 shows the overall configuration of a surgical operationsystem in accordance with the third embodiment;

[0031]FIG. 11A, FIG. 11B, and FIG. 11C show various types of handpieces;

[0032]FIG. 12 and FIG. 13 are concerned with a fourth embodiment of thepresent invention;

[0033]FIG. 12 shows the major portion of a surgical operation system inaccordance with the fourth embodiment;

[0034]FIG. 13 shows the configurations of an output switching unit andan extension unit;

[0035]FIG. 14 to FIG. 16 are concerned with a fifth embodiment of thepresent invention;

[0036]FIG. 14 shows the overall configuration of a surgical operationsystem in accordance with the fifth embodiment;

[0037]FIG. 15 is a block diagram showing the internal configuration of acamera control unit;

[0038]FIG. 16 shows a monitor on which port information or the like ispresented;

[0039]FIG. 17 and FIG. 18 are concerned with a sixth embodiment of thepresent invention;

[0040]FIG. 17 shows the overall configuration of a surgical operationsystem in accordance with the sixth embodiment;

[0041]FIG. 18 roughly shows the configuration of a scissors-likehandpiece;

[0042]FIG. 19 to FIG. 23 are concerned with a seventh embodiment of thepresent invention;

[0043]FIG. 19 is an explanatory diagram roughly showing theconfiguration of an ultrasonic operation system in accordance with theseventh embodiment;

[0044]FIG. 20 is a block diagram showing the internal configuration ofan ultrasonic operation system;

[0045]FIG. 21 shows the appearance of a handpiece having a built-in handswitch;

[0046]FIG. 22 shows an example of an image displayed on a monitor;

[0047]FIG. 23 is a flowchart describing connector selection for anexpansion unit;

[0048]FIG. 24 and FIG. 25 are concerned with an eighth embodiment of thepresent invention;

[0049]FIG. 24 is a block diagram showing the configuration of the majorportion of a camera control unit employed in the eighth embodiment;

[0050]FIG. 25 shows an example of an image displayed on a monitor;

[0051]FIG. 26 and FIG. 27 are concerned with a ninth embodiment of thepresent invention;

[0052]FIG. 26 is an explanatory diagram roughly showing theconfiguration of an ultrasonic operation system in accordance with theninth embodiment; and

[0053]FIG. 27 is a circuit block diagram showing the internalconfiguration of a main apparatus.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0054] (First Embodiment)

[0055] A first embodiment of the present invention will be describedwith reference to FIG. 1 to FIG. 7.

[0056] An ultrasonic operation system 1 in accordance with the firstembodiment of the present invention shown in FIG. 1 consists mainly of amain ultrasonic operation apparatus (hereinafter a main apparatus) 2, aplurality of treatment appliances, a footswitch 4, and a remote switch5. The main apparatus generates a driving signal. The plurality oftreatment appliances is connected to the main apparatus 2 so that theycan be disconnected freely. The plurality of treatment appliancesincludes, for example, a scissors-like handpiece 3A, a hook-likehandpiece 3B, and a trocar-like handpiece 3C. The footswitch 4 is turnedon or off in order to start or stop outputting energy. The remote switch5 is used for remote control.

[0057] According to the present embodiment, the ultrasonic operationsystem is used to incise or coagulate a lesion using ultrasonic energy.The handpieces 3I (where I denotes A, B, and/or C) has, as describedlater, an ultrasonic transducer incorporated therein. The main apparatus2 has an oscillatory circuit incorporated therein so as to apply adriving signal to each ultrasonic transducer.

[0058] An operator display panel 6, an operator panel 7, connectors 9A,9B, and 9C, selection switches 10A, 10B, and 10C, a remote switchconnector 11 b, and a loudspeaker 12 are exposed on the face of the mainapparatus 2. Connector pulses 8A, 8B, and 8C spliced to the ends ofcables 8 extending from the scissors-like handpiece 3A, hook-likehandpiece 3B, and trocar-like handpiece 3C are joined with theconnectors 9A, 9B, and 9C so that they can be disjoined freely. Theselection switches 10A, 10B, and 10C are arranged on the operator panel7 and used to select any connector 9I. A remote switch connector plug 11a (see FIG. 2) attached to a cable extending from the remote switch 5 isjoined with the remote switch connector 11 b. The loudspeaker 12 is usedto inform a result of selection with sound. A foot switch connector 13 b(see FIG. 2) with which a footswitch plug 13 a attached to a cableextending from the footswitch 4 is exposed on a rear panel on the backof the main apparatus 2.

[0059] The handpiece 9I has an elongated sheath 14I and an operator unit(or hand-held member) 15I formed at the back (proximal) end of thesheath 14I. An ultrasonic transducer 23 (represented by an ultrasonictransducer incorporated in the scissors-like handpiece 3A in FIG. 2) isincorporated in the operator unit 15I.

[0060] The scissors-like handpiece 3A and hook-like handpiece 3B haveoperator handles 17A and 17B respectively. The operator handle 17A or17B is manipulated with the fingers of an operator's hand in order toopen or close a distal treatment member 16A or 16B for the purpose of anultrasonic treatment intended for coagulation or any other cure.

[0061] In contrast, the trocar-like handpiece 3C has a cylindricalhand-held member 15C thereof directly held by an operator. A distaltreatment member 16C of the trocar-like handpiece 3C is used for atreatment.

[0062] In the present embodiment, the handpiece 9I has a hold detectionsensor 18I that detects (recognizes) whether the handpiece is held.

[0063] Specifically, the scissors-like handpiece 3A and hook-likehandpiece 3B have sensors 18A and 18B, which serve as hold detectingmeans for recognizing that the handpieces are held, embedded in theoperator handles 17A and 17B respectively. In contrast, the trocar-likehandpiece 3C has a sensor 18C disposed on the periphery of thecylindrical operator unit 15C thereof.

[0064] When an operator holds the handpiece 9I to be used with his/herhand, the main apparatus 2 detects (recognizes) the hold owing to anoutput of the sensor 18I. Thus, the handpiece 9I capable of outputtingultrasonic energy can be selected and the footswitch 4 can be stepped onin order to start outputting ultrasonic energy. This results in improvedmaneuverability.

[0065] Moreover, the remote switch 5 includes three selection switches19A, 19B, and 19C that are used to select the connectors 9A, 9B, and 9Crespectively.

[0066]FIG. 2 shows the internal configuration of the main apparatus 2.

[0067] The main apparatus 2 includes an oscillatory circuit 21 and aselector switch 22. The oscillatory circuit 21 produces a driving signalwith which ultrasonic oscillations are generated. The selector switch 22serves as a switching means for selectively applying the driving signal,which is produced by the oscillatory circuit 21, to the three connectors9I (also referred to as output ports).

[0068] The driving signal sent from the oscillatory circuit 21 passesthrough a contact i of the selector switch 22 that is closed, andtravels over a driving line 27 a contained in the cable 8 through theconnector 9I connected to the contact i. The driving signal is thenapplied to the ultrasonic transducer 23 incorporated in the handpiece3I. At this time, when an On switch of the footswitch 4 is stepped on,ultrasonic oscillations are generated.

[0069] The ultrasonic oscillations are propagated to the distaltreatment member 16I over an ultrasound propagation member. When thetreatment member 16I is brought into contact with a tissue concerned,the tissue is incised, coagulated, or anyhow treated.

[0070] Moreover, a signal detection line 27 b coupled to the sensor 18Ialso runs through the cable 8. A detection signal produced by the sensor18I is applied to a sensor circuit 24I in the main apparatus 2 by way ofthe connector plug 8I and connector 9I.

[0071] The sensor circuit 24A, 24B, or 24C judges (recognizes) from theoutput signal of the sensor 18I whether the handpiece 3I is held, andoutputs a result of judgment to a selection circuit 25.

[0072] Based on the output signal of the sensor circuit 24A, 24B, or24C, the selection circuit 25 selects the contact i of the selectorswitch 22 so that the driving signal will be applied to the ultrasonictransducer 23 in the handpiece 3I having the sensor 18I that has judgedthat the handpiece is held.

[0073] A selection signal induced with a press of the selection switch10I exposed on the operator panel 7 and a selection signal induced witha press of the selection switch 19I included in the remote switch 5 arealso applied to the selection circuit 25. When an operator presses anyof the selection switches 10I and 19I, the connections of theoscillatory circuit 21 via the selector switch 22 are switched so thatthe contact i whose selection is instructed will be closed.Consequently, a driving signal can be output to the ultrasonictransducer 23 in the handpiece 3I connected to the closed contact i.

[0074] A control circuit 26 responsible for control of the wholeapparatus is incorporated in the main apparatus 2. For example, when thefootswitch 4 is stepped on, a signal induced with the stepping istransferred to the control circuit 26. The control circuit 26 controlsthe oscillatory circuit to start or stop oscillation (or in other words,start or stop outputting oscillatory energy).

[0075] Moreover, when the operator panel 7 is used to set an energylevel, the control circuit 26 controls output of oscillations producedby the oscillatory circuit 21 according to the set value.

[0076] When the contacts i of the selector switch 22 are switched basedon a signal sent from the selection circuit 25, information indicatingwhich of the contacts i is closed is communicated from the selectioncircuit 25 to the control circuit 26. The control circuit 26 in turnvisually indicates the information or the connector 9I (or port number)connected to the closed contact i using the operator display panel 6.Alternatively, the control circuit 26 audibly notifies the informationor the connector using the loudspeaker 12.

[0077] Next, the sensor 18A (18B or 18C) serving as a hold detectingmeans will be described with reference to FIG. 3.

[0078] A hold detecting method adopted herein is based on judgment froma change in electrostatic capacitance.

[0079] A sensing device 30 included in the sensor 18A consists of twometallic electrodes 31 juxtaposed on an insulating plate. The sensingdevice 30 is electrically connected to the capacitance sensor circuit24A included in the main apparatus 2 over signal lines 27 b extendingfrom the two electrodes 31.

[0080] When an operator's hand is placed over the two electrodes 31, anelectrostatic capacitance offered by the two electrodes 31 changes. Thecapacitance sensor circuit 24A detects (recognizes) the change, andproduces a selection signal. Accordingly, the contacts i of the selectorswitch 22 are switched.

[0081] When a handpiece has a handle like the one shown in FIG. 4A(handpiece 3A or 3B), the sensing device 30 composed of the twoelectrodes 31 should be embedded in an inner wall of a stationary handle32 a of the operator handle 17A or 17B or of a movable handle 32 bthereof.

[0082] When a handpiece employed is the trocar-like handpiece 3C likethe one shown in FIG. 4B, the two electrodes 31 should be disposed at,for example, upper and lower points on the hand-held member 15C of thehandpiece. In this case, incorrect sensing can be avoided. Namely, whenthe handpiece 3C is, for example, placed by the side of a patient,although an operator does not hold the handpiece 3C, an electrostaticcapacitance changes. Consequently, it may be incorrectly sensed that thehandpiece 3C is held.

[0083] Next, an example of circuitry of the capacitance sensor circuit24A (or 25B or 24C) will be described with reference to FIG. 5.

[0084] The capacitance sensor circuit 24A consists mainly of anoscillatory circuit 35, a Wheatstone bridge 36, a comparator 37, and afilter 38. An oscillatory signal sent from the oscillatory circuit 35 isapplied to the Wheatstone bridge 36, and the sensing device 30 isconnected to the Wheatstone bridge 36. The comparator 37 judges a statesensed by the sensing device 30 from an output signal of the Wheatstonebridge 36. The filter 38 provides a binary-coded signal associated withthe sensed state according to an output of the comparator 37.

[0085] The oscillatory circuit 35 includes, for example, an inverter(realized with a Schmitt circuit) and produces a signal whose frequencyranges from several kilohertz to several hundred kilohertz. Anoscillatory output of the oscillatory circuit 35 is applied to theWheatstone bridge 36 having four impedance devices including the sensingdevice 30 connected in the form of a bridge. More particularly, theoscillatory output is applied to a node between resistors R1 and R2 andto a node between a capacitor C1 and one terminal of the sensing device30.

[0086] A signal used to detect a potential at a node between theresistor R1 and the other terminal of the sensing device 30 and a signalused to detect a potential at a node between the resistor R1 and thecapacitor C1 are applied to the input terminals of the comparator 37. Itis thus detected whether the potentials are balanced.

[0087] To be more specific, one of four impedance devices constitutingthe Wheatstone bridge 36 is replaced with the sensing device 30 composedof the two electrodes 31 and included in the handpiece 3I. Consequently,a change in a capacitive component can be detected as a change dependenton whether an operator's hand is placed over the two electrodes 31.Eventually, it can be recognized that an operator holds the handpiece3I.

[0088] For example, when the sensing device 30 is not held, acapacitance offered by the electrodes is small and an impedance offeredthereby is high. The potential at the sensing device 30 is thereforehigher than the potential at the capacitor C1. An output of thecomparator is therefore driven low.

[0089] When the holding device 30 is held and the electrostaticcapacitance is large, the potential at the sensing device 30 is lowerthan the potential at the capacitor C1. The output of the comparator istherefore driven high. The capacitance of the capacitor C1 or theresistances of the resistors R1 and R2 are determined to meet the aboveconditions.

[0090] In this case, an output of the sensing device is modulated withan oscillatory output (alternating output), and passed through thefilter 38. The filter 38 has the capability of a low-pass filter to passa component whose frequency is lower than an oscillating frequency atwhich the oscillatory output is provided, and consists of a resistor R3and a capacitor C2. Consequently, an output signal of the filter 38makes a low-to-high transition along with a change of the state of thehandpiece into a held state.

[0091] As mentioned above, according to the present embodiment, theconnector plug 8I attached to the cable extending from the handpiece 3Iis joined with the connector 9I formed on the main apparatus 2. When anoperator presses the selection switch 10I on the operator panel 7 or theselection switch 19I included in the remote switch 5, the handpiece 3Ithe operator wants to use is selected. When outputting energy is startedwith a step on the footswitch 4, an operation can be performed. Thehandpiece 3I has the sensor 18I for detecting a hold embedded in itsportion to be held by an operator. In the main apparatus 2, an outputsignal of the sensor 18I is checked, and the contacts i of the selectorswitch 22 are automatically switched so that an ultrasonic drivingsignal will be applied to the held handpiece 3I. Consequently, anoperation can be performed.

[0092] Operations to be exerted by the present embodiment having theforegoing components will be described with reference to FIG. 6. Asshown in FIG. 1, one handpiece 3I or a plurality of handpieces 3Iincluding the scissors-like handpiece 3A is connected to the mainapparatus 2 for treatment.

[0093] For example, the handpiece 3A is, as shown in FIG. 2, connectedto the main apparatus 2. When the operator handle 17A of the handpiece3A is held, a detection signal associated with the held state is sentfrom the sensor 18A to the sensor circuit 24A.

[0094] Based on the detection signal, the sensor circuit 24A sends aselection signal, which indicates that the handpiece 3A is held, to theselection circuit 25. The selection circuit 25 judges that the selectionsignal has been sent from the sensor circuit 24A out of the plurality ofsensor circuits 24A, 24B, and 24C.

[0095] Consequently, the selection circuit 25 sends a switching controlsignal to the selector switch 22 so that an output line extending fromthe oscillatory circuit 21 will be routed to the connector 9A connectedto the held handpiece 3A, or in other words, a contact a will beselected. A result of selection performed by the selection circuit 25 iscommunicated to the control circuit 26, and presented on the operatordisplay panel 6 and/or notified using the loudspeaker 12.

[0096] As mentioned above, when the handpiece 3A or the like is heldactually, the connections of the oscillatory circuit 21 via the selectorswitch 22 are automatically switched based on an output signal of thesensor circuit 24A. Alternatively, the selection circuit 25 may make ajudgment from whether the selection switch 10I on the operator panel 7or the selection switch 19I included in the remote switch 5 is pressed.Based on a result of judgment, the selector switch 22 may be acted toselect any of the connections.

[0097] Actions to be performed in the main apparatus have been describedbriefly. Selecting any of the output ports (connectors 9I) on the mainapparatus 2 is performed as described in FIG. 6.

[0098] The selection circuit 25 judges at step S1 in FIG. 6 whether anyof the selection switches 10A to 10C on the operator panel 7 has beenpressed. If no selection switch is pressed, it is judged at step S2whether any of the selection switches 19A to 19C included in the remoteswitch 5 has been pressed. If no selection switch is pressed, it isjudged at step S3 whether a selection signal has been received from anyof the sensor circuits 24A to 24C. If no selection signal is received,control is returned to step S1.

[0099] If the judgment at any of steps S1 to S3 is made in theaffirmative, control is passed to step S4. Control is then given toselect any of the contacts i of the selector switch 22 according to aselection signal induced with a press of any of the selection switches10A to 10C on the operator panel 7 or the selection switches 19A to 19Cincluded in the remote switch 5, or a selection signal sent from any ofthe sensor circuits 24A to 24C. Consequently, a driving signal will beapplied through the output port (any of connectors 9A to 9C) connectedto the selected contact.

[0100] For example, if it is judged at step S1 that the selection switch10A on the operator panel 7 has been pressed, a signal induced with thepress is transferred to the selection circuit 25. The selection circuit25 performs a selecting (switching) action to close the contact a of theselector switch 22.

[0101] If none of the selection switches 10A to 10C on the operatorpanel 7 is pressed and the selection switch 19A included in the remoteswitch 5 has been pressed, a signal induced with the press istransferred to the selection circuit 25. The selection circuit 25performs an action of selecting any of the contacts of the selectorswitch 22.

[0102] None of the switches 10A to 10C and 19A to 19C may be pressed,but a signal indicating that the handpiece 3I has been selected may betransferred to the selection circuit 25 owing to any of the sensors 18Ato 18C, which are included in the handpieces 3I and serve as holdrecognizing means, and the sensor circuits 24A to 24C incorporated inthe main apparatus 2. In this case, any of the contacts of the selectorswitch 22 is selected based on the signal.

[0103] Moreover, when an output port is selected, the selected outputport is informed an operator by means of a sound generated from theloudspeaker 12 or using a display means that is the operator displaypanel 6. Control is then returned to step S1.

[0104] As mentioned above, a hold detecting means can be constructedmerely by including two electrodes in a handpiece. The selection switch10I on the operator panel 7 or the selection switch 19I included in theremote switch 5 need not be pressed. Nevertheless, whichever of thehandpieces 3I an operator holds can be automatically recognized, and theoperator can use the held handpiece. This leads to drastically improvedmaneuverability.

[0105] In the aforesaid embodiment, the sensor 18I and capacitancesensor circuit 24I are used as a hold detecting means. Alternatively, asshown in FIG. 7, an infrared sensor 39 may be adopted as the sensingdevice 30 serving as the sensor 18I included in the handpiece 3I, and aninfrared sensor circuit 40 may be incorporated in the main apparatus 2.

[0106] The infrared sensor 39 consists mainly of an infrared emittingdevice and an infrared detecting device (infrared detectionphototransistor or photodiode). The infrared emitting device emitsinfrared light. The infrared detecting device detects infrared lightemitted from the infrared emitting device. Herein, an amount of infraredlight received by the infrared detecting device varies largely dependingon whether a handpiece is held.

[0107] An output signal of the infrared detecting device is sent to theinfrared sensor circuit 40. The infrared sensor circuit 40 judgeswhether the handpiece is held.

[0108] A result of selecting an output port may be notified by voicecomposed within the main apparatus 2.

[0109] The present embodiment has advantages described below.

[0110] When it is detected based on an output of the hold detectionsensor 18I embedded in the handpiece 3I that the handpiece 3I isactually held, the handpiece is automatically selected so that thehandpiece can output treatment energy. Once the handpiece 3I is held, anoperator can use the handpiece 3I for treatment but need not changehandpieces. This leads to improved user friendliness, that is, greatlyimproved maneuverability.

[0111] Moreover, treatment will not be suspended because handpieces neednot be changed. Treatment can be achieved smoothly.

[0112] (Second Embodiment)

[0113] Next, the second embodiment of the present invention will bedescribed with reference to FIG. 8 and FIG. 9. FIG. 8 shows the distalpart of a scissors-like handpiece 3A′. In the present embodiment, an LED41A is disposed near the treatment member 16A projecting from the tip ofa sheath 14A.

[0114] To be more specific, the scissors-like handpiece 3A′ is differentfrom the scissors-like handpiece 3A described in relation to the firstembodiment in a point that the LED 41A is disposed near the treatmentmember 16A projecting from the tip of the sheath 14 a. Moreover, ahook-like handpiece 3B′ shown in FIG. 9 has an LED 41B disposed near thetreatment member 16B thereof.

[0115]FIG. 9 is an explanatory diagram concerning the overallconfiguration of an ultrasonic operation system 51 in accordance withthe second embodiment. The ultrasonic operation system 51 consistsmainly of a main apparatus 52, handpieces 3A′ and 3B′, the footswitch 4,a remote switch 5′, and an endoscope 53 used to observe a region to beoperated on.

[0116] The main apparatus 52 included in the present embodiment isdifferent from the main apparatus 2 included in the first embodiment ina point that LEDs 54A to 54C are disposed near the selection switches10A to 10C located on the operator panel 7.

[0117] Moreover, according to the present embodiment, a cable 8′ isdifferent from the cable 8 included in the first embodiment in a pointthat the cable 8′ contains a signal line coupled to the LED 41I. Thecable 8′ is routed to the control circuit 26 (see FIG. 2) included inthe main apparatus 52 by way of the connector plug 8I and connector 9I.

[0118] Moreover, the remote switch 5′ included in the present embodimentis different from the remote switch 5 included in the first embodimentin a point that LEDs 55I are disposed near the selection switches 19I.

[0119] The other components are identical to those of the firstembodiment. The same reference numerals will be assigned to componentsidentical to those of the first embodiment, and the description of thecomponents will be omitted.

[0120] Next, operations to be exerted by the present embodiment will bedescribed below.

[0121] One of the plurality of handpieces 3A′ and 3B′ is selected owingto the remote switch 5′ and the hold detecting means employed even inthe first embodiment. When the handpiece 3I′ to be used is selected, forexample, when the scissors-like handpiece 3A is selected, the LED 41Adisposed near the distal end of the handpiece 3A emits light. Therefore,an operator readily identifies the handpiece 3A′ that can output energywhile treating a lesion under observation through the endoscope 53.

[0122] Moreover, the LED 55I disposed near the selection switch 19Iincluded in the remote switch 5′ emits light, and the LED 54I disposednear the selection switch 10I located on the operator panel 7 of themain apparatus 52 emits light. Thus, a result of selection is notified.

[0123] According to the present embodiment, even when an operator isperforming an operation using the endoscope 53, the operator canidentify the selected handpiece 31′ without being distracted from animage produced by the endoscope 53. This leads to improvedmaneuverability. The present embodiment provides the same advantages asthe first embodiment does.

[0124] (Third Embodiment)

[0125] Next, a third embodiment of the present invention will bedescribed with reference to FIG. 10 to FIG. 1C.

[0126] As shown in FIG. 10, in a (endoscopic) high-frequency/ultrasonicsurgical operation system 61 in accordance with the third embodiment ofthe present invention, a counter electrode plate 64 is interposedbetween an operating table 62 and a patient 63 lying down on theoperating table 62.

[0127] An electrode on the counter electrode plate 64 is connected to ahigh-frequency generator 65 over a cable. A rigid endoscope 66, ascissors-like handpiece 67, a rod-like handpiece 68, and a hook-likehandpiece 69 are inserted into the abdomen of the patient 63 over asheath that is not shown.

[0128] A TV camera head 71 with a built-in imaging device is mounted onthe back end of the rigid endoscope 66. The TV camera 71 is connected toa camera control unit (hereinafter CCU) 72, and processes a signalproduced by the imaging device. A standard video signal produced by theCCU 72 is transferred to a TV monitor 73. An endoscopic image picked upby the imaging device is displayed on the display screen of the TVmonitor 73.

[0129] The scissors-like handpiece 67, rod-like handpiece 68, andhook-like handpiece 69 are connected to the high-frequency generator 65and an ultrasonic generator 75 via an output switching unit 74 forswitching routes of an output line extending from each of thegenerators.

[0130] The high-frequency generator 65 and ultrasonic generator 75 areconnected to footswitches 76 and 77 respectively which are turned on oroff in order to start or stop outputting high-frequency or ultrasonicenergy.

[0131] Moreover, the output switching unit 74 has, for example, threeports a, b, and c. A hand-held switch 79 including a port a selectionswitch 78 a, a port b selection switch 78 b, and a port c selectionswitch 78 c used to select the ports a, b, and c respectively isconnected to the output switching unit 74.

[0132] An ultrasonic connector attached to a cable extending from thescissors-like handpiece 67 is joined with an ultrasound output connector81 a formed on the output switching unit 74. An active-cord mechanismcontained in the cable is coupled to a high-frequency output connector82 a.

[0133] An ultrasonic connector attached to a cable extending from therod-like handpiece 68 is joined with an ultrasound output connector 81 bformed on the output switching unit 74. An active-cord mechanismcontained in the cable is coupled to a high-frequency output connector82 b. An ultrasonic connector attached to a cable extending from thehook-like handpiece 69 is joined with an ultrasound output connector 81c formed on the output switching unit 74. An active-cord mechanismcontained in the cable is coupled to a high-frequency output connector82 c.

[0134] The output switching unit 74 has a port a selection indictor 83a, a port b selection indicator 83 b, and a port c selection indictor 83c.

[0135] As shown in FIG. 11A, the scissors-like handpiece 67 consistsmainly of a probe 85 a and a transducer 86 a attached to the back end ofthe probe 85 a. A handle 87 a is disposed at the back end of thetransducer 86 a. The handle 87 a is manipulated in order to turn amovable piece of a clamping member 88 a projecting from the tip of theprobe and thus clamp a lesion to be treated.

[0136] The rod-line handpiece 68 consists of, as shown in FIG. 11B, aprobe 85 a and a transducer 86 b. The probe 85 b is hollowed, and thehollow is connected to a suction unit 90 by way of a suction tube 89.

[0137] The hook-like handpiece 69 consists of, as shown in FIG. 11C, aprobe 85 c and a transducer 86 c. A hook 87 c is formed as the distalpart of the probe 85 c.

[0138] Next, operations to be exerted by the present embodiment will bedescribed below.

[0139] With the rigid endoscope 66, scissors-like handpiece 67, rod-likehandpiece 68, and hook-like handpiece 69 inserted in the body of thepatient 63, an operator observes the distal parts of the handpieces byviewing an image produced by the rigid endoscope 66. In other words, aview image picked up by the rigid endoscope 66 is converted into anelectrical signal by the TV camera head 71. The electrical signal isthen converted into a standard video signal by the CCU 72. Consequently,the view image is displayed on the TV monitor 73.

[0140] While viewing the image on the TV monitor 73, the operator movesthe scissors-like handpiece 67 out of the handpieces 67 to 69 to adesired position in a region to be operated on. The operator presses theport c selection switch 78 c included in the hand-held switch 79 so asto set an energy output port to the port c of the output switching unit74.

[0141] The state that the port c has been selected is indicated by theport c selection indicator 83 c on the output switching unit 74.Supposing the peritoneum of the patient 63 is incised in an early stageof an operation, the operator uses the hook-like handpiece 69 to hookthe peritoneum with the hook 87 c, and then steps on the footswitch 76.

[0142] A signal induced with the stepping of the footswitch 76 istransferred to the high-frequency generator 65, whereby high-frequencyenergy is fed to a high-frequency input connector, which is not shown,on the output switching unit 74. Since the port c selection switch 78 chas been selected, the high-frequency energy fed to the high-frequencyinput connector is transferred to the probe 85 c through thehigh-frequency output connector 82 c. The high-frequency energy flowsinto the counter electrode plate 64 through the peritoneum, and returnsto the high-frequency generator 65. The peritoneum is incised with thehigh-frequency energy passing through the peritoneum.

[0143] When the energy level may be low, an operator steps on thefootswitch 77. A signal induced with the stepping of the footswitch 77is transferred to the ultrasonic generator 75. Ultrasonic energy is thenfed to an ultrasound input connector, which is not shown, on the outputswitching unit 74. Since the port c selection switch 78 c has beenselected, the ultrasonic energy fed to the ultrasound input connector istransferred to the probe 85 c through the ultrasound output connector 81c. Eventually, the peritoneum is incised.

[0144] In short, an operator can switch the incising energies to beoutput from the hook-like handpiece 69 merely by changing thefootswitches 77 and 76 to be stepped on. When an operation progresses, avessel may have to be treated. In this case, the operator presses theport a selection switch 78 a included in the hand-held switch 79 so asto set an energy output port to the port a of the output switching unit74.

[0145] In this case, the port c selection indicator 83 c is put out, andthe port a selection indicator 83 a is lit. The operator manipulates thehandle 87 a of the scissors-like handpiece 67 to clamp a vessel with theclamping member 88 a. The operator then steps on the footswitch 77,whereby a signal induced with the stepping of the footswitch 77 istransferred to the ultrasonic generator 75. Ultrasonic energy is fed tothe ultrasound input connector, which is not shown, on the outputswitching unit 74.

[0146] Since the output port a has been selected, the ultrasonic energyfed to the ultrasound input connector is propagated to the clampingmember 88 a of the scissors-like handpiece 67 through the ultrasoundoutput connector 81 a. Consequently, the vessel clamped by the clampingmember 88 a is cut while being coagulated.

[0147] Moreover, if the necessity of incising any other tissue arisesduring the above treatment, the operator steps on the footswitch 76while pressing the distal part of the scissors-like handpiece 67 againstthe tissue to be incised. Consequently, high-frequency energy ispropagated from the high-frequency generator 75 to the clamping member88 a of the scissors-like handpiece 67. The tissue in contact with theclamping member 88 a is thus incised.

[0148] If the operator finds a malignant tissue and wants to remove thetissue, the operator presses the port b selection switch 78 b includedin the hand-held switch 79. Consequently, the port b of the outputswitching unit 74 is set as an energy output port. In this case, theoperator steps on the footswitch 77 with the distal part of the rod-likehandpiece 68 pressed against the malignant tissue. Consequently,ultrasonic energy is propagated from the ultrasonic generator 75 to theprobe 85 b. Eventually, the malignant tissue is destroyed andemulsified.

[0149] The suction unit 90 is connected to the probe 85 b by way of thesuction tube 89. The emulsified malignant tissue is sucked by thesuction unit 90 by way of the suction tube 89 and removed from theregion to be operated on. At this time, if any peripheral tissuehemorrhages, the operator brings the distal part of the probe 85 b intocontact with the hemorrhaging tissue, and steps on the footswitch 76.Consequently, high-frequency energy is propagated to the probe 85 b,whereby the hemorrhage is arrested.

[0150] The present embodiment provides the advantage described below.

[0151] According to the present embodiment, if various treatments aregiven during one operation, a probe whose shape is optimal for eachtreatment can be readily selected and used. This leads to a greatreduction in an operating time.

[0152] (Fourth Embodiment)

[0153] Next, a fourth embodiment of the present invention will bedescribed with reference to FIG. 12 and FIG. 13. The same referencenumerals will be assigned to components identical to those of the thirdembodiment, and the description of the components will be omitted.

[0154] As shown in FIG. 12, a (first) extension unit 92 can be freelydetachably attached to a main output switching unit 91. A (second)extension unit 93 can be freely detachably attached to the extensionunit 92. In FIG. 12 and FIG. 13, the extension unit 92 is attached tothe main output switching unit 91.

[0155] The main output switching unit 91 has a port a ultrasound outputconnector 94 a, a port a high-frequency output connector 95 a, a port aselection switch 96 a, a port b ultrasound output connector 94 a, a portb high-frequency output connector 95 b, and a port b selection switch 96b arranged on an operator panel thereof.

[0156] As shown in FIG. 13, an ultrasonic joint plug 111, ahigh-frequency joint plug 112, and a control plug 110 are formed on theright side surface of the main output switching unit 91.

[0157] As shown in FIG. 12 and FIG. 13, the extension unit 92 has a portc ultrasound output connector 94 c, a port c high-frequency outputconnector 95 c, and a port c selection switch 96 c arranged on the frontpanel thereof.

[0158] The extension unit 93 has a port d ultrasound output connector 94d, a port d high-frequency output connector 95 d, and a port d selectionswitch 96 d arranged on the front panel thereof.

[0159] As shown in FIG. 13, an ultrasonic joint connector 114, ahigh-frequency joint connector 115, and a control connector 113 areformed on the left side surface of the extension unit 92. The outputswitching unit 91 and extension unit 92 are freely detachably attachedto each other using an attaching/detaching mechanism that is not shown.At this time, the output switching unit 91 and extension unit 92 arejuxtaposed so that the ultrasonic joint plug 111 will be automaticallyjoined with the ultrasonic joint connector 114, the high-frequency jointplug 112 will be automatically joined with the high-frequency jointconnector 115, and the control plug 110 will be automatically joinedwith the control connector 113.

[0160] Moreover, an ultrasonic joint plug 97, a high-frequency jointplug 98, and a control plug 99 are arranged on the right side surface ofthe extension unit 92. The ultrasonic joint plug 97, high-frequencyjoint plug 98, and control plug 99 are joined with an ultrasonic jointconnector 100, a high-frequency joint connector 101, and a controlconnector 102 formed on the extension unit 93 that has the samestructure as the extension unit 92 as shown in FIG. 12.

[0161] As shown in FIG. 13, the ultrasonic generator 75 is connected tothe main output switching unit 91 through an ultrasound input connector103. The high-frequency generator 65 is connected thereto through ahigh-frequency input connector 104.

[0162] The ultrasound input connector 103 is connected to a port aswitching relay 120, a port b switching relay 121, and an extension unitrelay 122. The high-frequency input connector 104 is connected to theport a switching relay 120, port b switching relay 121, and extensionrelay 122. The port a switching relay 120 is connected to the port aultrasound output connector 94 a and port a high-frequency outputconnector 95 a.

[0163] The port b switching relay 121 is connected to the port bultrasound output connector 94 b and port b output connector 95 b. Theextension unit relay 122 is connected to the ultrasonic joint plug 111and high-frequency joint plug 112. A control circuit 105 is incorporatedin the main output switching unit 91, and connected on a control bus106.

[0164] Control lines extending from the port a switching relay 120, portb switching relay 121, and extension unit relay 122 are routed to thecontrol bus 106. The port a selection switch 96 a and port b selectionswitch 96 b located on the front panel are connected on the control bus106. The control bus 106 is routed to the control plug 110.

[0165] A control bus 107 is routed to the control connector 113 formedon the extension unit 92. A port c switching relay 123 and an extensionunit relay 124 are incorporated in the extension unit 92. The ultrasoundjoint connector 114 is connected to the port c switching relay 123 andextension unit relay 124. The high-frequency joint connector 115 isconnected to the port c switching relay 123 and extension unit relay124.

[0166] The relay 123 is connected to the port c ultrasound outputconnector 94 c and port c high-frequency output connector 95 c. Theextension unit relay 124 is connected to the ultrasound joint plug 97and high-frequency joint plug 98.

[0167] Control lines extending from the port c switching relay 123 andextension unit relay 124 are routed to the control bus 107. The port cselection switch 96 c and control plug 99 are connected on the controlbus 107.

[0168] Next, operations to be exerted by the present embodiment will bedescribed below.

[0169] When three handpieces are employed in the same manner as they arein the third embodiment, the extension unit 92 is attached to the outputswitching unit 91. Consequently, the ultrasound joint plug 111 is joinedwith the ultrasound joint connector 114, the high-frequency joint plug112 is joined with the high-frequency connector 115, and the controlplug 110 is joined with the control connector 113.

[0170] When the control plug 110 and control connector 113 are joined,information of the joint is communicated to the control circuit 105. Thecontrol circuit 105 closes the extension unit relay 122. On the otherhand, nothing is joined with the control plug 99. The control circuit105 keeps the extension unit relay 124 open.

[0171] The scissors-like handpiece 67 is plugged in to the port a, therod-like handpiece 68 is plugged in to the port b, and the hook-likehandpiece 69 is plugged in to the port C.

[0172] When an operator wants to treat a vessel using the scissors-likehandpiece 67, the operator presses the port a selection switch 96 a onthe output switching unit 91. A signal induced with the press of theport a selection switch 96 a is transferred to the control circuit 105.The control circuit 105 closes the port a switching relay 120.Consequently, ultrasonic energy and high-frequency energy can bepropagated to the scissors-like handpiece through the port a.

[0173] When an operator wants to resect a malignant tissue using therod-like handpiece 68, the operator presses the port b selection switch96 b on the output switching unit 91. A signal induced with the press ofthe port b selection switch 96 b is transferred to the control circuit105. The control circuit 105 opens the port a switching relay 120 andcloses the port b switching relay 121. Consequently, ultrasonic energyand high-frequency energy can be propagated to the rod-like handpiece 68through the port b. The same applies to a case where the port c isselected.

[0174] When an operator intends to use only two types of handpieces, theoperator detaches the extension unit 92 from the output switching unit91. When the control plug 110 and control connector 113 are disjoined,the control circuit 105 opens the extension unit relay 122.Consequently, the operator performs an operation with any handpiecesplugged in to the port a and port b.

[0175] A plurality of extension units may be attached to the extensionunit 92. Operations to be exerted in this case are nearly identical tothe aforesaid ones to be exerted when the extension unit 92 is attachedto the output switching unit. The description of the operations willtherefore be omitted.

[0176] The present embodiment provides the advantage described below.

[0177] According to the present embodiment, the number of ports whichare disposed on the output switching unit and to which handpieces areplugged in can be set to any value. Consequently, the components of asystem can be arranged neatly within a limited operating space.

[0178] According to the third and fourth embodiments, energy can bepropagated to a selected intended handpiece without the necessity ofremoving a plurality of handpieces from a region to be operated onduring an operation. This leads to highly improved operating efficiency.

[0179] (Fifth Embodiment)

[0180] A fifth embodiment of the present invention will be describedwith reference to FIG. 14 to FIG. 16. An object of the presentembodiment is to provide an endoscopic surgical operation system makingit possible to readily and reliably select any of a plurality of typesof handpieces for use without being distracted from a lesion to betreated. The background of the present embodiment will be describedbelow.

[0181] Japanese Unexamined Patent Publication No. 2000-271135 hasdisclosed a switching means for feeding ultrasonic energy, which isgenerated by one apparatus (ultrasonic operation apparatus), selectivelyto a plurality of handpieces. Herein, a connector expansion unit isconnected between an ultrasonic treatment handpiece and the ultrasonicoperation apparatus.

[0182] Assuming that the foregoing components are used in combinationwith a plurality of handpieces to perform an operation, it isunnecessary to replace a handpiece connected to the ultrasonic operationapparatus with another every time a handpiece to be used is changed toanother. The connector expansion unit switches the handpieces to makeone handpiece usable.

[0183] Moreover, the connections through the switching means can beswitched using a selection switch disposed on the connector expansionunit or a hand-held switch.

[0184] However, according to the Japanese Unexamined Patent PublicationNo. 2000-271135, a selected handpiece cannot be identified until energyis actually output.

[0185] Moreover, a means for checking if a selected switch is associatedwith an intended handpiece must judge whether the handpiece andultrasonic operation apparatus are actually connected to each other overa cable.

[0186] Therefore, every time an operator who uses handpieces changes thehandpieces, the operator has to turn his/her eyes from a living tissueto be treated to the apparatus. The present embodiment attempts toresolve this drawback.

[0187] The present embodiment is analogous to the first embodiment. Thesame reference numerals will be assigned to components identical tothose of the first embodiment, and the description of the componentswill be omitted.

[0188] A surgical operation system 1B in accordance with the presentembodiment is different from the system 1 shown in FIG. 1 in a pointthat a main apparatus 2B having another ability added thereto issubstituted for the main apparatus 2 and an endoscope system 129 isincluded.

[0189] The endoscope system 129 consists mainly of an optical endoscope(hereinafter endoscope) 130, a camera head 131, a light source unit 133,a camera control unit (hereinafter CCU) 135, and a monitor 136. Theendoscope 130 enables endoscopic examination. The camera head 131 ismounted on the endoscope 130. An imaging device for producing anendoscopic image is incorporated in the camera head 131. The lightsource unit 133 supplies illumination light to the endoscope 130 over alight guide cable 132. The CCU 135 is connected to the camera head 131over a signal cable 134, and processes a signal sent from the imagingdevice to produce a video signal. The monitor 136 is connected to theCCU 135 and displays an endoscopic image. Herein, the CCU 135 isconnected to the main apparatus 2B over a communication cable 137.

[0190]FIG. 15 shows the CCU 135 included in the endoscope system 129 andpart of the main apparatus 2B.

[0191] The light source unit 133 has a built-in light source lamp 138.Illumination light emanating from the light source lamp 138 is convergedand propagated over the light guide cable 132. The illumination light isfurther propagated over a light guide 140 that runs through an insertionunit 139 included in the endoscope 130, and emitted from the distal endof the endoscope 130.

[0192] An optical image of an illuminated object such as a lesion isinitially passed through an objective 141, and then propagated through arelay lens system 142. The optical image is picked up by the imagingdevice 144 incorporated in the camera head 131 mounted on an eyepieceunit 143.

[0193] A signal resulting from photoelectric conversion performed by theimaging device 144 is transferred to an analog processing circuit 148included in the CCU 135 over the signal cable 134. After subjected toanalog processing such as amplification and color separation, the signalis converted into a digital form by an A/D conversion circuit 149.

[0194] The signal is subjected to white balance control or the like by adigital processing circuit 150, and then transferred to a charactersuperimposition circuit 151. A digital video signal output from thecharacter superimposition circuit 151 is converted into a standard videosignal via a D/A conversion circuit 152 and a post-processing circuit153, and transferred to the monitor 136.

[0195] Moreover, a CPU 154 is included in the CCU 135, and controls, forexample, the digital processing circuit 150 included in the CCU 135.

[0196] Moreover, a character generation circuit 155 is included in theCPU 154, generates characters according to a control signal sent fromthe CPU 154, and communicates them to the character superimpositioncircuit 151.

[0197] The CPU 154 is connected to a CPU 26A included in the controlcircuit 26 through a connector 157 formed on the main apparatus 2 overthe communication cable 137 that has one end thereof spliced to aconnector 156. The CPU 154 transfers information to or from the CPU 26A.

[0198] The main apparatus 2B is different from the main apparatus 2shown in FIG. 2 in a point that a resistance detection (typeidentification) circuit 161 is included for detecting the resistance ofa type identification resistor Ri included in each handpiece 3I, andthus identifying the type of handpiece. In FIG. 15, the handpiece 3A isplugged in to the connector 9A, the resistance of the typeidentification resistor incorporated in the handpiece 3A shall bedenoted as Ra.

[0199] The resistance detection circuit 161 has three input terminalsthereof connected to the type identification resistors Ri throughcontacts in the connectors 9A to 9C. The resistors Ri are connected tocontacts in the connectors 8I. The resistance detection circuit 161senses a resistance associated with the type of handpiece 3I that isplugged in to the connector 9A, 9B, or 9C.

[0200] The resistance detected by the resistance detection circuit 161is communicated to the CPU 26A. The CPU 26A references a lookup table(LUT) 162, in which identification information is written in advance, tojudge with what handpiece type the detected resistance is associated.Instead of detecting the resistance, a reference voltage may be dividedby a known resistance and the resistance of the type identificationresistor Ri, and a handpiece type may be judged from the resultantfractions of the voltage.

[0201] In FIG. 15, the scissors-like handpiece 3A plugged in to theconnector 9A (port A) is identified. The CPU 26A records in a registerwithin the CPU 26A the identified handpiece type and the port number ofthe port to which the handpiece is plugged in.

[0202] Moreover, when the selection switch 10I on the main apparatus 2Bor the remote switch 5 is pressed in order to select the handpiece 3I tobe used, a port I to which the handpiece is plugged in is communicatedto the CPU 26A in the control circuit 26.

[0203] When it is thus instructed to select the handpiece 3I, the CPU26A transfers the handpiece type indicating the type of handpiece 3I andthe port number, which are recorded in the register, to the CPU 154. Thehandpiece type and port number are then, as shown in FIG. 16, indicatedon the display screen of the monitor 136.

[0204] When an operator holds the handpiece 3I the operator wants to useinstead of pressing the selection switch 10I or the like to instructselection of a handpiece, the port I to which the handpiece 3I isplugged in is detected by the sensor circuit 24I and communicated to theCPU 26A in the control circuit 26.

[0205] Even in this case, the CPU 26A transfers the handpiece type andport number to the CPU 154. The handpiece type and port number are thenindicated on the display screen of the monitor 136.

[0206] As described in relation to the first embodiment, when thehandpiece 3I is held, the contacts i of the selector switch 22 areswitched so that a driving signal can be applied to the port I selectedby the selection circuit 25.

[0207] In the present embodiment, when the handpiece 3I is selected orheld, the routes of the output line extending from the oscillatorycircuit are switched so that a driving signal can be, as described inrelation to the first embodiment, applied to the port I to which thehandpiece 3I is plugged in. The type of handpiece 3I and the port numberof the port I are indicated on the monitor 136.

[0208] An operator checks the type of handpiece 3I selected or heldwhile viewing an endoscopic image displayed on the display screen of themonitor 136. The operator need not turn his/her eyes to the mainapparatus 2B to check the selected handpiece. That is to say, even whena plurality of handpieces is used, a selected or held handpiece can beidentified reliably without the necessity of turning eyes. This leads toimproved maneuverability.

[0209] Major operations to be exerted by the present embodiment will bedescribed briefly.

[0210] When a surgical procedure is performed under endoscopicobservation, the endoscope system 129 is prepared as shown in FIG. 14.Moreover, the communication cable 137 extending from the CCU 135 iscoupled to the main apparatus 2B.

[0211] Moreover, a plurality of handpieces or a single handpiece that isintended to be used during the surgical procedure is connected to themain apparatus 2B.

[0212] For example, when the scissors-like handpiece 3A is, as shown inFIG. 15, plugged in to the port A (connector 9A) formed on the mainapparatus 2B, the resistance detection circuit 161 senses the resistanceof the type identification register Ra incorporated in the connector 8A.The resistance is communicated to the CPU 26A. The CPU 26A referencesthe lookup table 162 to check the identification information writtentherein, and judges that the scissors-like handpiece 3A has been pluggedin to the port A. The CPU 26A stores the information in the internalregister or the like.

[0213] When the hook-like handpiece 3B is plugged in to the connector9B, the CPU 26A judges that the hook-like handpiece 3B has been pluggedin to the port B, and stores the information.

[0214] The endoscope 130 and handpiece 3A are inserted into thepatient's abdomen using a trocar that is not shown, whereby a lesion isobserved. An endoscopic image of the lesion is displayed on the displayscreen of the monitor 136. An operator views the endoscopic image. Whenthe operator holds, for example, the scissors-like handpiece 3A for useduring an operation, a detection signal associated with the held stateis transferred to the sensor circuit 24A as described in relation to thefirst embodiment.

[0215] Based on the detection signal, the sensor circuit 24A transmits aselection signal, which indicates that the handpiece 3A is held, to theselection circuit 25. The selection circuit 25 recognizes that it hasreceived the selection signal from the sensor circuit 24A out of theplurality of sensor circuits 24A, 24B, and 24C.

[0216] Consequently, the selection circuit 25 transmits a switchingcontrol signal to the selector switch 22 so that the output lineextending from the oscillatory circuit 21 will be routed to theconnector 9A to which the held handpiece 3A is plugged in. The result ofselection performed by the selection circuit 25 is communicated to theCPU 26A in the control circuit 26, presented on the operator displaypanel 6, and notified using the loudspeaker 12.

[0217] Moreover, when the result of selection performed by the selectioncircuit 25 is communicated to the CPU 26A, the CPU 26A communicates theselected handpiece type and port number to the CPU 154 in the CCU 135over the communication cable 137.

[0218] The CPU 154 causes the character generation circuit 155 togenerate characters associated with the received information. Thecharacters are communicated to the character superimposition circuit151, and superimposed on the endoscopic image. A video signalrepresenting the endoscopic image on which the characters aresuperimposed is transferred to the monitor 136. Consequently, the heldhandpiece type and port number are, as shown in FIG. 16, indicated withthe endoscopic image displayed on the display screen of the monitor 136.

[0219] Referring to FIG. 16, HP-1 is displayed to indicate the handpiecetype, and Port A is displayed to indicate the port number.

[0220] Therefore, an operator can check the type of held handpiece 3Aand the output port to which the handpiece is plugged in while viewingthe endoscopic image displayed on the monitor 136, but will not bedistracted from the endoscopic image.

[0221] After checking the type of handpiece 3A and the output port, theoperator may step on the footswitch 4 to turn on the footswitch 4.Consequently, ultrasonic energy is output from the distal end of theselected handpiece 3A, and incision or any other treatment can becarried out.

[0222] After the scissors-like handpiece 3A is used to performtreatment, the scissors-like handpiece 3A may be released and thehook-like handpiece 3B may be held instead. In this case, the routes ofthe output line extending from the oscillatory circuit are switched sothat the output line will be routed to the handpiece 3B. Moreover, thehandpiece type (for example, HP-2) and the port number (for example,Port B) are indicated on the monitor 136.

[0223] When the trocar-like handpiece 3C is held, the same indicationsare displayed.

[0224] The selection switch 10I located on the operator panel 7 or theselection switch 19I included in the remote switch 5 may be pressedinstead of holding the handpiece 3A or pressing. In this case, theselection circuit 25 switches the contacts of the selector switch 22.Even in this case, the type of selected handpiece and a port number towhich the handpiece is plugged in are indicated on the monitor 136.

[0225] According to the present embodiment, even when an operator wantsto perform a surgical procedure using ultrasonic treatment applianceswhile viewing an endoscopic image, the type of ultrasonic treatmentappliance plugged in to each port is identified and indicated on thescreen of the monitor on which the endoscopic image is displayed. Theoperator can identify the type of ultrasonic treatment applianceactually plugged in to each port without turning his/her eyes from theviewed endoscope. The present embodiment provides an environment inwhich an operation can be performed smoothly.

[0226] In the present embodiment, when a handpiece to be used is held,the system is set to a mode in which the handpiece is used to performtreatment. An operator can therefore more easily continue a cure withoutlooking away from a tissue being treated than when the operatordesignates a handpiece using the hand-held switch.

[0227] Moreover, an operator can select a handpiece by himself/herselfin a clean zone.

[0228] According to the aforesaid constituent features, two sets ofcharacters can be displayed. Alternatively, one set of characters alonemay be displayed. However, at least one set of characters should bedisplayed.

[0229] When the two kinds of information are presented, if twohandpieces of the same type are prepared for use, either of thehandpieces now selected for use can be identified based on a port numberindicated.

[0230] (Sixth Embodiment)

[0231] Next, a sixth embodiment of the present invention will bedescribed with reference to FIG. 17 and FIG. 18. Ahigh-frequency/ultrasonic surgical operation system 161 in accordancewith the sixth embodiment shown in FIG. 17 is analogous to thehigh-frequency/ultrasonic surgical operation system 61 in accordancewith the third embodiment shown in FIG. 10.

[0232] The high-frequency/ultrasonic surgical operation system 161 has acounter electrode plate 164 interposed between an operating table 162and a patient 163 who lies down on the operating table 162.

[0233] The counter electrode plate 164 is connected to a high-frequencygenerator 165 over a cable. A rigid endoscope 166, a scissors-likehandpiece 167A, a rod-like handpiece 167B, and a hook-like handpiece167C are inserted in the abdomen of the patient 163 through a sheaththat is not shown.

[0234] The scissors-like handpiece 167A, rod-like handpiece 167B, andhook-like handpiece 167C have nearly the same structures as thosedescribed in conjunction with FIG. 11A, FIG. 11B, and FIG. 1C. Treatmentusing ultrasonic waves and treatment using a high-frequency electricsignal can be carried out. Moreover, the present embodiment includeshold detection sensors 185 a, 185 b, and 185 c that will be describedlater.

[0235] A TV camera head 171 having a built-in imaging device is mountedon the back end of the rigid endoscope 166. The TV camera 171 isconnected to a CCU 172 that processes a signal produced by the imagingdevice. A standard video signal produced by the CCU 172 is transferredto a TV monitor 173, whereby an endoscopic image picked up by theimaging device is displayed on the display screen of the TV monitor 173.

[0236] The scissors-like handpiece 167A, rod-like handpiece 167B, andhook-like handpiece 167C are connected to the high-frequency generator165 and an ultrasonic generator 175 via an output switching unit 174that switches the routes of an output line extending from each of thegenerators.

[0237] The high-frequency generator 165 and ultrasonic generator 175 areconnected to footswitches 176 and 177 respectively. Output ofhigh-frequency energy or ultrasonic energy can be started or stopped byturning on or off the footswitch 176 or 177.

[0238] Moreover, the output switching unit 174 has, for example, threeports a, b, and c formed thereon. A remote switch 179 including portselection switches 178 a, 178 b, and 178 c used to select the ports a,b, and c respectively is connected to the output switching unit 174.

[0239] The three ports a, b, and c are composed of ultrasonic ports 181a, 181 b, and 181 c and high-frequency ports 182 a, 182 b, and 182 c.The handpieces 167A, 167B, and 167C are plugged in to the ports.

[0240] To be more specific, an ultrasonic connector attached to a cableextending from the scissors-like handpiece 167A is joined with theultrasound output connector 181 a on the output switching unit 174. Anactive-cord mechanism contained in the cable is spliced to thehigh-frequency output connector 182 a.

[0241] An ultrasonic connector attached to a cable extending from therod-like handpiece 167B is joined with the ultrasound output connector181 b formed on the output switching unit 174. An active-cord mechanismcontained in the cable is spliced to the high-frequency output connector182 b. An ultrasonic connector attached to a cable extending from thehook-like handpiece 167C is joined with the ultrasound output connector181 c formed on the output switching unit 174. An active-cord mechanismcontained in the cable is spliced to the high-frequency output connector182 c.

[0242] The output switching unit 174 switches the routes of a drivingoutput line extending from the generator 165 or 175 so that the drivingoutput line will be routed to the port i to which the handpiece 167I isplugged in.

[0243] Moreover, the output switching unit 174 has selection indicators183 a, 183 b, and 183 c, each of which indicates that the port a, b, orc has been selected, formed thereon.

[0244] In the present embodiment, the handpieces 167A, 167B, and 167Care provided with hold detection sensors 185 a, 185 b, and 185 c each ofwhich detects (or recognizes) that the handpiece 167A, 167B, or 167C isheld.

[0245] To be more specific, the scissors-like handpiece 167A has thesensor 185 a embedded in the operator handle thereof. The rod-likehandpiece 167B and hook-like handpiece 167C have the sensors 185 b and185 c respectively embedded on the peripheries of the hand-held membersthereof with which an operator hold the handpieces.

[0246] Outputs of the sensors 185 a to 185 c are transferred to a holddetector 186. The hold detector 186 transmits a signal, with which ahandpiece detected to be held is selected, to the output switching unit174. The held handpiece is then made usable.

[0247] Moreover, the output switching unit 174 is connected to a CPU 187included in the CCU 172 over a communication cable. The output switchingunit 174 transmits information of the port i, to which the handpiece167I detected to be held by the hold detector 186 is plugged in, to theCPU 187. The CPU 187 controls a character generating means included inthe CCU 172, superimposes characters on an endoscopic image displayed onthe monitor 173, and thus indicates the port i to which the selectedhandpiece is plugged in.

[0248] As mentioned above, the handpieces 167A to 167C have nearly thesame structures as those described in conjunction with FIG. 11A to FIG.1C. For example, the scissors-like handpiece 167A is structured asroughly shown in FIG. 18.

[0249] An ultrasonic transducer 191 to be ultrasonically oscillated isstowed in an operator unit 190 from which an operator handle 189 isprojected. An ultrasonic driving signal is applied to the ultrasonictransducer 191 over an ultrasonic driving line 192. Ultrasonicoscillations produced by the ultrasonic transducer 191 are propagated toa stationary blade 194 a included in a distal treatment member 194 overan ultrasound propagation rod 193, thus causing the stationary blade 194a to oscillate.

[0250] When the handpiece 167A is held with the operator handle 189 andthe operator handle 189 is opened or closed, the movement of theoperator handle is conveyed to the distal end of the ultrasoundpropagation rod 193 over an operation wire 195. This causes a movableblade included in the treatment member 194 to pivot. Ultrasonic wavesare applied to a tissue clamped by the stationary blade 194 a andmovable blade, whereby the tissue is resected.

[0251] Moreover, the ultrasound propagation rod 193 is electricallycoupled to a high-frequency output line 196. High-frequency currentflows along the ultrasound propagation rod 193 after passing through thehigh-frequency output line 196. The high-frequency current then flowsinto a tissue via the stationary blade 194 a, whereby the tissue istreated with high-frequency power.

[0252] Moreover, the operator handle 189 has the sensor 185 a. Thesensor 185 a is connected to the hold detector 186 over a sensor line197.

[0253] The other components are identical to those described in relationto the third embodiment and fifth embodiment.

[0254] The present embodiment provides the same advantages as the thirdembodiment does. In addition, the port i to which the held handpiece167I is plugged in is indicated on the monitor 173.

[0255] Next, operations to be exerted by the present embodiment will bedescribed briefly.

[0256] The components of the system are connected to one another asshown in FIG. 17. An operator inserts the rigid endoscope 166,scissors-like handpiece 167A, rod-like handpiece 167B, and hook-likehandpiece 167C in the body of the patient 163, and observes the distalparts of the handpieces using the rigid endoscope 166. Namely, an imageto be viewed owing to the rigid endoscope 166 is converted into anelectrical signal by the TV camera head 171, and the electrical signalis converted into a standard video signal by the CCU 172. Eventually,the image is displayed on the display screen of the TV monitor 173.

[0257] While viewing the image on the TV monitor 173, the operatorholds, for example, the scissors-like handpiece 167A out of thehandpieces 167A to 167C so as to move the handpiece to a desiredposition in an region to be operated on.

[0258] The hold causes an output of the sensor 185 to change. The holddetector 186 detects that the sensor 185 a embedded in the scissors-likehandpiece 167A is blocked with the fingers of a hand holding thehandpiece. The hold detector 186 then transmits an associated detectionsignal to the output switching unit 174.

[0259] The output switching unit 174 causes the driving output lineextending from the generator 165 or 175 to conduct electricity to theport a to which the scissors-like handpiece 167A is plugged in. At thistime, the selection indicator 183 a is lit to indicate that the port ahas been selected.

[0260] In this state, when the footswitch 176 or 177 is turned on,driving energy generated from the generator 165 or 175 is output to thehandpiece 167A plugged in to the port a.

[0261] A signal sensed by the hold detector 186 is sent to the CPU 187in the CCU 172 via the output switching unit 174. The CPU 187 instructsgeneration of characters indicating the sensed port a. Consequently, theindication of the port a is displayed on the monitor 173 as shown inFIG. 17.

[0262] While viewing an endoscopic image, an operator can discern thatthe port a to which the handpiece 167A is plugged in has been selectedwithout the necessity of turning his/her eyes to the output switchingunit 174 to check if the port a has been selected.

[0263] The same applies to a case where the other handpiece 167B or 167Cis held.

[0264] The above description has been made on the assumption that thehandpiece is held. Alternatively, the remote switch 179 may bemanipulated. For example, when the port selection switch 178 a ispressed, similarly to when the handpiece 167A is held, the routes of theoutput line extending from the generator are switched, and theindication of the port a is displayed.

[0265] The present embodiment provides the same advantages as the thirdembodiment does. In addition, one of the plurality of handpieces 167A to167C held by an operator can be identified based on a press of theremote switch 179 or by the hold detector 186, and thus internallyselected. The result of selection is communicated to the CCU 172. Theinformation of a port to which the selected handpiece is plugged in issuperimposed on an endoscopic image displayed on the display screen ofthe TV monitor 173. The operator can therefore identify the handpiece tobe used without turning his/her eyes from the viewed endoscopic image.

[0266] (Seventh Embodiment)

[0267] Next, a seventh embodiment of the present invention will bedescribed with reference to FIG. 19 to FIG. 23.

[0268] In the present embodiment, a plurality of handpieces (serving assurgical appliances) is simultaneously connected to a main apparatus. Anexternal hand switch or a built-in hand switch is pressed to select ahandpiece to be used. The selected handpiece and whether the handpieceis active are indicated on a monitor.

[0269] As shown in FIG. 19, an ultrasonic operation system 251 inaccordance with the seventh embodiment of the present invention consistsmainly of a main apparatus 252, an expansion unit 253, a scissors-likehandpiece 203A, a hook-like handpiece 203C, a trocar-like handpiece203D, external hand switches 255, a footswitch 256, a remote switch 257,an optical endoscope (hereinafter endoscope) 300, a camera head 301, alight source unit 303, a camera control unit (hereinafter CCU) 305, anda monitor 306. The main apparatus 252 has a driving means, whichgenerates a driving signal as described later, incorporated therein. Thedriving signal sent from the driving means incorporated in the mainapparatus 252 is transferred to the expansion unit 253. Thescissors-like handpiece 203A, hook-like handpiece 203C, and trocar-likehandpiece 203D are plugged in to output ports (output terminals) formedon the expansion unit 253 so that they can be unplugged freely. Theexternal hand switches 255 are freely detachably attached to the lateralparts of the operator units of the handpieces. The footswitch 256 andexternal hand switches 255 are selectively used. The remote switch 257is connected to the expansion unit 253 so that it can be disconnectedfreely, and used to remotely select the output port 254 a, 254 b, or 254c. The endoscope 300 enables endoscopic examination. The camera head 301is mounted on the endoscope 300 and has a built-in imaging device thatpicks up an endoscopic image. The light source unit 303 suppliesillumination light to the endoscope 300 over a light guide 302. The CCU305 is connected to the camera head 301 over a signal cable 304, andprocesses a signal produced by the imaging device to produce a videosignal. The monitor 306 is connected to the CCU 305 and displays anendoscopic image.

[0270] Handpiece plugs 214 a, 214 c, and 214 d attached to cablesextending from the scissors-like handpiece 203A, hook-like handpiece203C, and trocar-like handpiece 203D are joined with the output ports254 a, 254 b, and 254 c respectively. Any of the handpieces can beselected for use.

[0271] A handpiece plug 214 b attached to a cable extending from thescissors-like handpiece 203B in which a built-in hand switch 220 ismounted as shown in FIG. 21 can be joined with an output port on theexpansion unit 253 so that the handpiece plug can be disjoined freely.The scissors-like handpiece 203B consists mainly of an elongated sheath211 b, an operator unit 212 b, and a treatment member 213 b. Theoperator unit 212 b communicates with the proximal end of the sheath 211b and is designed to lie near an operator's hand. The treatment member213 b is projected from the distal end of the sheath 211 b.

[0272] The treatment member 213 b has a clamping piece 216 b that issupported at the distal end of the sheath 211 b so that it can pivotfreely. The clamping piece 216 b approaches to or parts from the distalpart of a probe 215 b that runs through the sheath 211 b. The operatorunit 212 b includes a stationary handle 217 b and a movable handle 213b. When the movable handle 218 b is opened or closed relative to thestationary handle 217 b, the clamping piece 216 b of the treatmentmember 213 b can be approached to or parted from the distal part of theprobe 215 b. The scissors-like handpiece 203A shown in FIG. 19 has thesame structure.

[0273] As shown in FIG. 19, a front panel 261 of the main apparatus 252has a power switch 262, a display panel 263, and a hand switch connector264 formed thereon. The display panel 263 is used to indicate whether ahandpiece is active. Plugs attached to cables extending from theexternal hand switches 255 can be joined with the hand switch connector264 so that they can be disjoined freely.

[0274] A rear panel of the main apparatus 252 (not shown in FIG. 19) hasa footswitch connector 256 b formed thereon. A footswitch plug 256 aattached to a cable extending from the foot switch 256 is joined withthe footswitch connector 256 b so that it can be disjoined freely.

[0275] Moreover, an output port 252 a formed on the main apparatus 252is connected to an input port 253 a formed on the expansion unit 253over a joint cord 265. A driving signal sent from the driving meansincorporated in the main apparatus 252 is transferred to the expansionunit 253 by way of the output port 252 a, joint cord 265, and input port253.

[0276] The expansion unit 253 has connectors 271, 272, and 273,selection switches 274, 275, and 276, and a remote switch connector 278.The connectors 271, 272, and 273 have the same ability as the handswitch connector 263 formed on the main apparatus 252. The connectors255 a attached to the cables extending from the external hand switches255 are joined with the connectors 271, 272, and 273 so that they can bedisjoined freely. The selection switches 274, 275, and 276 are used tomanually select one of the output ports 254 a, 254 b, and 254 c. Theremote switch plug 257 a attached to the cable extending from the remoteswitch 257 is joined with the remote switch connector 278 so that it canbe disjoined freely.

[0277] Moreover, the rear panel of the main apparatus 252 has, as shownin FIG. 20, a connector 316 through which an output terminal statussignal is transmitted (via a control circuit 283 to be described later).The output terminal status signal is transmitted to the CCU 305 over ajoint cord 317, whereby whether an actually selected output terminal isactive is indicated on the monitor 306. This enables an operator todiscern which of the handpieces has been selected and whether theselected handpiece is active.

[0278] The CCU 305 is designed to produce a video signal from a signalsent from a charge-coupled device (hereinafter CCD) incorporated in thecamera head 301, and to display an endoscopic image on the monitor 306.On receipt of the output terminal status signal sent over the joint cord317, whether a selected handpiece is active is indicated with theendoscopic image displayed on the monitor 306.

[0279] The present embodiment includes an output switching means forswitching the output destinations of a driving signal, which is sentfrom the driving means incorporated in the main apparatus 252, accordingto a signal induced with a press of the external hand switch 255 orremote switch 257. Namely, the output switching means selects any of theoutput ports 254 a, 254 b, and 254 c formed on the expansion unit 253.

[0280] Next, the circuitry of the ultrasonic operation system 251 inaccordance with the present embodiment will be described in conjunctionwith FIG. 20.

[0281] The circuitry of the main apparatus 252 consists mainly of adrive circuit 281, a switch sense circuit 282, a display panel 263, anda control circuit 283.

[0282] The circuitry of the expansion unit 253 consists mainly of arelay 285 and a control circuit 286. The relay 285 switches the contactsthereof connected to the output ports 254 a, 254 b, and 254 c formed onthe expansion unit 253, and thus relays signal lines. The controlcircuit 286 controls switching of the contacts of the relay 285according to a signal induced with a press of the built-in hand switch220, external hand switch 255, or remote switch 257.

[0283] The control circuit 286 includes a latch or a memory that is notshown. When an output port is selected, the selected output port isrecorded until another output port is selected. In the drawing, thescissors-like handpiece 203A, the scissors-like handpiece 203B havingthe built-in hand switch 220, the external hand switch 255, and theremote switch 257 are connected to the expansion unit 253.

[0284] When the built-in hand switch 220, external hand switch 255, orremote switch 257 is pressed, any of the output ports 254 a, 254 b, and254 c is selected. When a signal induced with the press is applied tothe control circuit 286 included in the expansion connector 253, thecontrol circuit 286 controls the relay 285 to close the contact of therelay 285 connected to the selected output port. Moreover, the selectedoutput port is communicated to the switch sense circuit 282 in the mainapparatus 252.

[0285] A selected handpiece alone out of the built-in hand switch 220and external hand switches 255 is made usable. Each switch has twofeatures of enabling start or stop of outputting energy and of enablingselection of a handpiece. This confuses an operator. For this reason,when both switches A and B included in each hand switch are pressedsimultaneously, a signal for selecting an associated output port isinduced. When the switches A and B are pressed separately, a signal forstarting outputting a driving signal is induced.

[0286] To be more specific, when the switches A and B included in thebuilt-in hand switch 220 or external hand switch 255 are pressedsimultaneously, a signal induced is used to select any of the outputports 254 a, 254 b, and 254 c. When the switches A and B are pressedseparately, a signal induced is used to start or stop outputting adriving signal.

[0287] When any of the output ports 254 a, 254 b, and 254 c is selected,which of the output ports has been selected is indicated on the displaypanel 263 under control of the control circuit 286 (via the switch sensecircuit 282 and control circuit 283). At the same time, an outputterminal status signal is transferred to the CCU 305 through the outputconnector 316.

[0288] The camera head 301 is connected to the CCU 305 over the signalcable 304. The CCD 307 is incorporated in the camera head 301, andphotoelectrically converts an object image formed on the imaging surfaceof the CCD 307.

[0289] The endoscope 300 is a rigid endoscope such as a laparoscopeemployed in, for example, a surgical procedure. When the endoscope 300is connected to the light source unit 303 over the light guide 302,illumination light emanating from the light source unit 303 ispropagated over the light guide 302 and a light guide, which is notshown, running through the endoscope 300. The illumination light is thenirradiated to an object through the distal end of the endoscope 300.

[0290] Light reflected from the illuminated object is converged andpropagated by the endoscope 300. The CCD 307 incorporated in the camerahead 301 picks up an optical image sent from the endoscope 300 andphotoelectrically converts it.

[0291] An output signal of the CCD 307 in the camera head 301 istransferred to the CCU 305, and subjected to various kinds of signalprocessing by the CCU 305. In the CCU 305, the output signal of the CCD307 is transferred to an analog processing circuit 308 and convertedinto a digital form by an A/D conversion circuit 309.

[0292] A digital processing circuit 310 performs white balance controlor the like on a received signal, and transfers the signal to acharacter superimposition circuit 311. A digital video signal outputfrom the character superimposition circuit 311 passes through a D/Aconversion circuit 312 and a post-processing circuit 313. The digitalvideo signal is thus converted into a standard video signal andtransferred to the monitor 306.

[0293] The CPU 314 allows the CCU 305 to give various kinds of control.An output terminal status signal output through the output connector 316formed on the main apparatus 252 is transmitted to the CCU 305 over thejoint cord 317, and transferred to the CPU 314. In response to theoutput terminal status signal, the CPU 314 senses what output terminalis active, and gives an instruction to a character generation circuit315. In response to a signal received from the CPU 314, the charactergeneration circuit 315 communicates character information to thecharacter superimposition circuit 311.

[0294] The character superimposition circuit 311 superimposes thecharacter information on a digital video signal, and transfers the videosignal to a signal processing stage that is a succeeding stage.

[0295] The thus configured ultrasonic operation system 251 is used toperform ultrasonic treatment. For example, the treatment member 213 b ofthe scissors-like handpiece 203B having the built-in hand switch 220mounted therein is brought into contact with a region to be treatedwithin a living tissue. The built-in hand switch 220, external handswitch 255, or remote switch 257 is pressed in order to select an outputport. Consequently, the selected output port and whether the port isactive are, as shown in FIG. 22, indicated on the monitor 306.

[0296] Referring to FIG. 22, HP-1 which indicates that the output port 1through which energy is output to the first handpiece has been selected,and SW-A which indicates that the switch A has been selected aredisplayed adjacently to an endoscopic image on the monitor 106. Once anoperator looks at the display screen of the monitor 306 in which theendoscopic image is displayed, the operator readily learns the selectedhandpiece and whether the handpiece is active while viewing theendoscopic image. The operator would find the ultrasonic operationsystem user-friendly.

[0297] Selecting an output port using the built-in hand switch 220 orexternal hand switch 55 will be described in conjunction with FIG. 23.

[0298] For example, when the switch A (SW-A) and switch B (SW-B)included in the built-in hand switch 220 are pressed simultaneously, asignal induced is transferred to the control circuit 286 in theexpansion unit 253. The fact that the switches A and B are pressedsimultaneously is sensed (step S11). Control is then given to select theoutput port 254 a (step S12).

[0299] For giving control to select the output port 254 a, a signal forselecting the output port 254 a is transferred to the switch sensecircuit 282 in the main apparatus 252. Moreover, the relay 285 iscontrolled in order to close the contact of the relay 285 connected tothe output port 254 a.

[0300] The scissors-like handpiece 203B and the built-in hand switch 220which are currently in use are indicated on the monitor 306 and thedisplay panel 263 under control of the control circuit 283 in the mainapparatus 252 (step S13).

[0301] When the selection switch 274 on the front panel 271 formed onthe expansion unit 253 is pressed instead of simultaneously pressing theswitches A and B included in the hand switch, a signal induced with thepress is transferred to the control circuit 286 in the expansion unit253. The press of the selection switch 274 is thus sensed (step S14),and control is given in order to select the output port 254 a (stepS12). The selected output port is indicated on the monitor 306.

[0302] Furthermore, when the selection switch associated with the outputport 254 a and included in the remote switch 257 is pressed, similarlyto when the selection switch 274 on the expansion unit 253 is pressed,the press of the selection switch is sensed (step S15). Thereafter, asmentioned above, control is given in order to select an associatedoutput port, and the selected output port is indicated.

[0303] On the other hand, when the switch A or switch B included in thebuilt-in hand switch 220 is pressed independently, a signal induced withthe press is transferred to the control circuit 286 in the expansionunit 253. The press of the switch A or switch B is sensed (step S16 orS17). It is judged whether the pressed switch A or B is associated withthe already selected output port 254 a (step S18). If so, a signalinduced at the pressed switch A or B is transmitted to the mainapparatus 252 (step S19).

[0304] For example, when the output port 254 a is selected, a drivingcontrol signal is sent from the control circuit 283 in the mainapparatus 252 to the drive circuit 281. The driving signal sent from thedrive circuit 281 is applied to the handpiece 203B via the relay 285through the selected output port 254 a. Eventually, ultrasonic treatmentis carried out.

[0305] Moreover, the fact that the driving signal has been applied tothe handpiece 203B through the output port 254 a is indicated on thedisplay panel 263 under control of the control circuit 283, communicatedto the CCU 305, and indicated on the monitor 306. For example, anindication is displayed in order to indicate that the switch A has beenturned on. Moreover, when the switch B is turned off, an indicationsignifying that the switch B has been turned off is displayed (ornothing may be displayed).

[0306] Consequently, an operator in charge of an operation selects ahandpiece the operator wants to use. This leads to improvedmaneuverability and enables the operator to concentrate on theoperation. The operator can readily discern the selected handpiece andwhether the handpiece is active. Moreover, when a handpiece is selectedusing the built-in hand switch 220, the two features of the switch ofenabling start or stop of outputting energy and enabling selection of anoutput port can be utilized for different purposes without the necessityof including an additional hand switch line.

[0307] Furthermore, an operator can perform a surgical procedure whilelooking at the monitor 306 all the time. Even if the operator lies at aposition at which the operator cannot look at the display panel 263formed on the main apparatus 52 to check a result of switching theoutput ports, the operator can reliably discern whether a handpiece isactive merely by looking at the monitor 306. The operator can proceedwith the surgical procedure while enjoying user-friendliness.

[0308] (Eighth Embodiment)

[0309] Next, an eighth embodiment of the present invention will bedescribed with reference to FIG. 24 and FIG. 25. The configuration of asystem in accordance with the present embodiment is roughly the same asthat of the system in accordance with the seventh embodiment. FIG. 24shows part of a CCU.

[0310] In the present embodiment, the shapes of handpieces to begraphically indicated on the monitor 306 are recorded in advance in amemory. A pointing mark is displayed on the monitor 306. The pointingmark moves along with the movement of a handpiece.

[0311] The ultrasonic operation system in accordance with the presentembodiment adopts a CCU 305′ that is partly different from the CCU 305shown in FIG. 20 and has the circuitry shown in FIG. 24.

[0312] To be more specific, the CCU 305′ consists mainly of the digitalprocessing circuit 310, the CPU 314, a shape detection circuit 320, amemory 321, a comparison circuit 322, and a superimposition circuit 323.The shape detection circuit 320 produces shape data from a digital videosignal. The shapes of handpieces are recorded in advance in the memory321. The comparison circuit 322 compares produced shape data with theshapes recorded in the memory 321, and determines the shape of ahandpiece. Moreover, the comparison circuit 322 outputs positioninformation. The superimposition circuit 323 displays a pointing mark onthe monitor 306.

[0313] The circuits preceding the digital processing circuit 310 areidentical to those employed in the seventh embodiment. Moreover, thecircuits succeeding the D/A conversion circuit 312 to which an outputsignal of the superimposition circuit 323 is transferred are identicalto those employed in the seventh embodiment. The description of theidentical circuits will be omitted.

[0314] Similarly to the seventh embodiment, a signal produced by the CCD307 is subjected to predetermined processing in the CCU 305′, andtransferred to the digital processing circuit 310.

[0315] A digital video signal is divided into two signal components.

[0316] A method of detecting a shape of a handpiece or a positionthereof is described in, for example, Japanese Unexamined PatentPublication No. 8-164148. One of the two digital video signal componentsis transferred to the shape detection circuit 320.

[0317] The shape detection circuit 320 produces shape data includinginformation of edges of an entity from the digital video signal, andtransfers the data to the comparison circuit 322. The shapes of aplurality of handpieces are recorded in advance in the memory 321. Inresponse to an instruction issued from the CPU 314, the shape detectioncircuit 320 produces shape data of a selected handpiece and sends it tothe comparison circuit 322.

[0318] The comparison circuit 322 determines the shape of the selectedhandpiece according to the shape data sent from the shape detectioncircuit 320 by referencing the memory 321 in which the handpiece shapesare recorded. Furthermore, the comparison circuit 322 detects theposition of the handpiece and transfers the position information to thesuperimposition circuit 323.

[0319] The superimposition circuit 323 superimposes a pointing mark (anencircled letter A in FIG. 25) on the distal part of a handpiece imageaccording to the position information output from the comparison circuit322. The handpiece image is contained in an endoscopic image representedby the digital video signal output from the digital processing circuit310.

[0320] The pointing mark may be, as shown in FIG. 25, a symbol of A or Bdiscriminating an output terminal. Alternatively, the pointing mark maybe a color of blue or green associated with each output terminal.

[0321] Moreover, the CPU 314 receives an output terminal status signal,and records a selected output terminal in the memory 121.

[0322] As mentioned above, the pointing mark is superimposed on an imageof a selected handpiece displayed on the monitor 306. The pointing markfollows the movement of the handpiece. When the selected output terminalis changed to another, the pointing mark is superimposed on an image ofanother handpiece selected.

[0323] Consequently, an operator intuitively discriminates a currentlyselected handpiece from among a plurality of handpieces. The otheroperations and advantages are identical to those of the seventhembodiment.

[0324] (Ninth Embodiment)

[0325] Next, a ninth embodiment of the present invention will bedescribed with reference to FIG. 26 and FIG. 27.

[0326] According to the present embodiment, a keyboard of a personalcomputer is sealed with a sterilization cover so that it can be used ina clean zone to select a handpiece to be used.

[0327] An ultrasonic operation system 251′ shown in FIG. 26 is differentfrom the ultrasonic operation system 251 shown in FIG. 19 in a pointthat a personal computer 331 is connected to the main apparatus 252 overa communication cable 330. Moreover, a keyboard 332 of the personalcomputer 331 is sealed with a sterilization cover 333 for use.

[0328] Symbols indicating a handpiece selection key, an output startkey, and other keys are inscribed on the sterilization cover 333. Anoperator places the sterilization cover 33 on the keyboard 332 of thepersonal computer 331. The operator presses a predetermined key, wherebya control signal is transferred to the main apparatus 252 over thecommunication cable 330.

[0329] As shown in FIG. 27, one end of the communication cable 330 isspliced to a joint connector 334 formed on the main apparatus 252. Thecontrol signal is transferred to each of the control circuit 283 andswitch sense circuit 282.

[0330] Consequently, the keyboard 332 is used in the same manner as theexternal hand switch 255 or the built-in switch of a handpiece which areemployed in the seventh embodiment.

[0331] Moreover, a handpiece selected using the keyboard 332 and energyto be output are indicated on a display 335 of the personal computer331.

[0332] According to the present invention, the keyboard 332 is used. Thedisplay 335 of the personal computer 331 may be sealed with asterilization sheet so that the display 335 can be touched to enter acommand.

[0333] Embodiments that can be constructed by partly combining theaforesaid embodiments shall belong to the present invention.

What is claimed is:
 1. An energy-selective operation system comprising:a plurality of handpieces for generating predetermined energies; adriving signal generator for generating a driving signal with which saidplurality of handpieces is driven; an output switching unit forswitching the output destinations of the driving signal to select any ofsaid plurality of handpieces; selection signal generators, included insaid plurality of handpieces, for generating a selection signal whichindicates that any of said plurality of handpieces has been selected, anotifier for notifying information of a handpiece, from which theselection signal is transmitted, out of said plurality of handpieces;and a switching control unit for controlling said switching unit so thatthe output destinations of the driving signal will be switched to selectthe handpiece, from which the selection signal is transmitted, fromamong said plurality of handpieces.
 2. An energy-selective operationsystem according to claim 1 , wherein: said plurality of handpieces eachincludes a hand-held member to be held for treatment and a holddetecting device which detects that the hand-held member is held; andsaid selection signal generator transmits the selection signal to saidswitching control unit in response to a detection signal received fromsaid hold detecting device which has detected that said hand-held memberis held.
 3. An energy-selective operation system according to claim 1 ,further comprising: an imaging device for imaging a predetermined regionto be observed; a signal processor for producing a predetermined videosignal from an image signal produced by said imaging device; a displaydevice for displaying a predetermined view image according to the videosignal sent from said signal processor; and a superimposition unit forsuperimposing information of a handpiece, from which the selectionsignal is transmitted, on the view image displayed on said displaydevice.
 4. An energy-selective operation system according to claim 3 ,wherein said superimposition unit superimposes on a vide image displayedon said display device information of at least one of a type ofhandpiece from which the selection signal is transmitted, and a portwhich serves as an output destination and to which the handpiece fromwhich the selection signal is transmitted is plugged in.
 5. Anenergy-selective operation system according to claim 1 , wherein saidnotifier notifies whether a selected handpiece is active.
 6. Anenergy-selective operation system comprising: a plurality of handpiecesfor generating predetermined energies; a driving signal generator forgenerating a driving signal with which said plurality of handpieces isdriven; an output switching unit for switching the output destinationsof the driving signal sent from said driving signal generator to selectany of said plurality of handpieces; hand-held members included in saidplurality of handpieces and held for treatment; hold detecting devicesincluded in said hand-held members, said hold detecting devices eachdetecting whether said hand-held member is held, and producing apredetermined hold detection signal; and an output switching controlunit for receiving the hold detection signal, and controlling saidoutput switching unit that switches the output destinations of thedriving signal to select a handpiece from which the hold detectionsignal is transmitted.
 7. An energy-selective operation system accordingto claim 6 , further comprising a notifier for notifying information ofa handpiece, from which the hold detection signal is transmitted, out ofsaid plurality of handpieces.
 8. An energy-selective operation systemaccording to claim 7 , wherein said notifier notifies information of aport which serves as an output destination and to which a handpiece fromwhich the selection signal is transmitted is plugged in.
 9. Anenergy-selective operation system according to claim 6 , wherein saidplurality of handpieces each has a light emitting device that enablesdiscernment of a handpiece from which the hold detection signal istransmitted.
 10. An energy-selective operation system according to claim9 , wherein said light emitting device is located near the distal end ofeach handpiece.
 11. An energy-selective operation system according toclaim 6 , further comprising: an imaging device for imaging apredetermined region to be observed; a signal processor for producing apredetermined video signal from an image signal produced by said imagingdevice; a display device for displaying a predetermined view imageaccording to the video signal sent from said signal processor; and asuperimposition unit for superimposing information of a handpiece, ofwhich selection signal generator has generated the selection signal, onthe view image displayed on said display device.
 12. An energy-selectiveoperation system according to claim 6 , wherein said driving signalgenerator includes: a high-frequency output unit for applying a drivingsignal, with which high-frequency energy is output, to said handpiece;an ultrasound output unit for applying a driving signal, with whichultrasonic energy is output, to said handpiece; and a switching unit forswitching the driving signal sent from said high-frequency output unitand the driving signal sent from said ultrasound output unit.
 13. Anenergy-selective operation system according to claim 6 , wherein saidplurality of handpieces each generates predetermined energy to be usedfor treatment in response to the driving signal with whichhigh-frequency energy or ultrasonic energy is output.
 14. Anenergy-selective operation system according to claim 6 , wherein aplurality of different driving signals is applied to said plurality ofhandpieces.
 15. An energy-selective operation system according to claim6 , wherein said hold detecting device includes a sensor thatelectrically or optically detects whether said hand-held member is held.16. An energy-selective operation system according to claim 6 , whereinsaid plurality of handpieces each includes an identifier with which thetype of handpiece can be identified.
 17. An energy-selective operationsystem according to claim 16 , further comprising an identification unitfor identifying said identifier and identifying the type of handpieceassociated with said identifier.
 18. An energy-selective operationsystem according to claim 16 , wherein said identifier is identified andthe type of handpiece associated with said identifier is indicated. 19.An energy-selective operation system according to claim 6 , wherein:said output switching control unit gives control according to the holddetection signal so as to switch the output destinations of the drivingsignal; and said output switching control unit also gives controlaccording to a selection signal induced with a press of a remote controlswitch so as to switch the output destinations of the driving signal tothus apply the driving signal to a handpiece selected with the selectionsignal.
 20. An energy-selective operation system according to claim 6 ,further comprising an output switch that is turned on or off in order tostart or stop outputting predetermined energy from a handpiece which isselected by switching the output destinations of the driving signalusing said output switching unit.
 21. An operation apparatus comprising:an energy generator for generating predetermined energy in response to adriving signal generated by a driving signal generator; a handpiece bodyhaving said energy generator incorporated therein; a hand-held memberincluded in said handpiece body and held for treatment; a hold detectingdevice, included in said handpiece body, for detecting that saidhand-held member is held when said hand-held member is held, andproducing a hold detection signal; and a driving signal input devicefor, when said hold detecting device produces the hold detection signal,receiving the driving signal sent from said predetermined driving signalgenerator, and transferring the driving signal to said energy generator.22. An operation apparatus according to claim 21 , further comprising anotifier for, when said hold detecting device produces the holddetection signal, notifying that said hand-held member is held.
 23. Anoperation apparatus according to claim 21 , wherein said energygenerator generates ultrasonic energy.
 24. An operation apparatusaccording to claim 21 , wherein said energy generator generateshigh-frequency energy.
 25. An operation system comprising: a drivingsignal generator including a driving signal output device through whicha driving signal is applied to a handpiece that is supposed to generateoperating energy; an expansion unit to be plugged in to said drivingsignal output device so that it can be unplugged freely, said expansionunit including a selector for selectively transmitting the drivingsignal, which is received through said driving signal output device,through any one of a plurality of output terminals; a remote controllerfor remotely controlling said driving signal output device via saidexpansion unit; a switching unit for switching the destinations of thedriving signal received by said expansion unit according to a signalinduced with a manipulation performed on said remote controller so thatthe driving signal will be transmitted through one of said plurality ofoutput terminals; a status signal generator for generating an outputterminal status signal that indicates whichever of said output terminalshas been selected by said switching unit and whether the selected outputterminal is active; and a display device for indicating based on theoutput terminal status signal whether the selected output terminal isactive.
 26. An operation system according to claim 25 , wherein saidremote controller is mounted on said handpiece.
 27. An operation systemaccording to claim 25 , wherein said remote controller is a keyboard.28. An operation system according to claim 25 , wherein said handpieceis an ultrasonic handpiece for generating ultrasonic energy as theoperating energy.
 29. An operation system according to claim 25 ,further comprising a display device for displaying an endoscopic imageand an imaging device for enabling display of the endoscopic image onsaid display device, wherein: said imaging device enables indication ofwhether a selected output terminal is active on said display deviceaccording to the output terminal status signal.
 30. An operation systemaccording to claim 25 , further comprising: shape data representingshapes of handpieces serving as surgical appliances; a display devicefor displaying an endoscopic image; and an imaging device for enablingdisplay of the endoscopic image on said display device, wherein saidimaging device includes a pointing mark generating device and a trackingdevice for tracking a handpiece that serves as a surgical appliance andthat is identified based on shape data.
 31. An endoscopic operationsystem comprising: an endoscope used to observe an intracorporealregion; a signal processor for processing an image signal, which isproduced by an imaging device incorporated in said endoscope, to producea video signal; an endoscopic image display device for displaying anendoscopic image, which is picked up by said imaging device, accordingto the video signal; a plurality of operating handpieces for generatingtreatment energies; a driving signal generator for generating a drivingsignal which causes any operating handpiece out of said plurality ofoperating handpieces to generate treatment energy; an output switchingunit, connected between said driving signal generator and said pluralityof operating handpieces, for switching the routes of an output line overwhich the driving signal is transmitted; hand-held members included insaid plurality of operating handpieces and held for treatment; holddetecting devices, included in said hand-held members, said holddetecting devices each producing a predetermined hold detection signalwhen detecting that said hand-held member is held; an output switchingcontrol unit for receiving the hold detection signal, and controllingsaid output switching unit so that the output destinations of thedriving signal will be switched to select an operating handpiece fromwhich the hold detection signal is transmitted; and a superimpositionunit for superimposing information of a handpiece, from which the holddetection signal is transmitted, on an image displayed on saidendoscopic image display device.
 32. An endoscopic operation systemaccording to claim 31 , wherein said operating handpieces are ultrasonicoperation handpieces for generating ultrasonic energy as the treatmentenergy.
 33. An endoscopic operation system according to claim 31 ,wherein said operating handpieces are high-frequency electric operationhandpieces for generating high-frequency energy as the treatment energy.